Insurance and Orthodontics with aligners

Many teenagers need braces, but more and more adults are choosing for orthodontic treatment as well for either medical or aesthetic reasons. An investment in straightening your teeth and all of its benefits will last you a lifetime, because orthodontics offers many health benefits in addition to straight teeth and a beautiful smile. If you would like to learn more about this, read the blog ‘Why choose braces later in life’.

Will orthodontic care be reimbursed by the insurance?

Did you know that orthodontic treatment is not included in the Dutch basic health insurance? Instead, orthodontic treatment is always covered by supplementary or dental insurance. Often there is an age limit attached as well, which is usually set at 18 years and sometimes at 22 years. For adults, reimbursement is therefore often more limited or not even possible.

If you want to start an orthodontic treatment, the months November and December are the perfect time to take a closer look at your current health insurance policy. This way you can easily check if your current insurance suits your wish for a orthodontic treatment and adjust your policy if necessary.

Waiting time and limited reimbursement

Orthodontic care is less and less reimbursed by health insurance companies and especially for adults the reimbursement seems to disappear. This is understandable however, because someone will not insure orthodontic care if that specific treatment is not expected and health insurers take this into account. When taking out an insurance, pay close attention to the terms and conditions that your insurer applies to a reimbursement for orthodontic care. Examples of these are:

  • Waiting period of 1 or 2 years
  • Acceptance after a questionnaire
  • Maximum amount reimbursed, regardless of total costs
  • Medical necessity required
  • One-off payment on the policy instead of a reimbursement per calendar year

Do you want to start an Invisalign® treatment in 2021? Then now is the best time to find out if you can adjust your policy. Treatments with aligners fall under category 7 / F-codes 

Insurance or paying yourself?

Comparing reimbursements for orthodontics between health insurers is difficult and complex. If insurance does not provide sufficient coverage and is therefore too expensive, you can put the premium money aside and save for your orthodontic treatment yourself. This may even end up being the cheaper option for you.

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